Postsurgical Therapy for the Individual with Cerebral Palsy

Abstract

Orthopedic surgery is quite common in the management of children and youth with cerebral palsy, utilized to correct and prevent musculoskeletal deformity and optimize movement function. It is most successful when undertaken as a process involving a multidisciplinary team of surgeons, medical and rehabilitation specialists, and physical and/or occupational therapists. The achievement of functional mobility goals happens through an intentional and thoughtful process of preoperative preparation, perioperative management, and intensive postsurgical rehabilitation within the setting of a medical team with family partnership. Postsurgical therapy begins acutely in the hospital setting to initiate range of motion, early mobility, and caregiver education. The acute therapy sessions also address assistive device and seating system needs. The transition from acute care to other therapy settings such as home-based, inpatient rehabilitation, comprehensive outpatient rehabilitation, school-based, or episodic outpatient physical therapy will depend on patient, caregiver, and medical team goals (Miller, Cerebral Palsy. Springer Science and Business Media, New York, 2005a). Implementation of these services may occur sequentially, concurrently, or individually and should be accompanied by a home exercise program. The goals of postsurgical therapy for the child with cerebral palsy include: preserving and progressing available joint range of motion and strength, improving functional use of affected limbs, advancing functional mobility, increasing comfort, and inhibiting reoccurrence of the corrected deformity.